Performance of bipolar steroid-eluting epicardial leads in the young—12 years single-center experience

Background: To document a single-center experience for patients implanted with bipolar, steroid-eluting epicardial leads.Methods: Retrospective review for patients with epicardial pacemakers implanted secondary to either postoperative or congenital complete heart block (CCHB), over a 12 years study period. All patients were identified through a surgical database.Results: Forty-one patients met the inclusion criteria, with 26 patients following postoperative repair and 15 patients with CCHB with a total of 68 epicardial leads. The mean follow-up duration was 4.5±3 years. The mean weight and age at implantation were 6.4±5.3 kg and 1.2±2.1 years, respectively. The mean generator longevity was at 5.5±1.1 years. Twenty-nine patients (71%) received ventricular single-chamber device and another 12 patients (29%) had a dual-chamber pacemaker at initial implant. Fifteen patients (37%) required pacing system reinterventions. The median lead failure time was 51 months (range: 5 to 107 months). The incidence of lead events was 10%. The actuarial freedom from reoperation at 9.8 years was 76.5%. Two patients died from complications of cardiomyopathy.Conclusions: Medtronic 4968 lead performance was excellent. Despite the young cohort, the incidence of lead failure was low. Indeed, bipolar steroid-eluting leads offers a reliable pacing option for the young, preserving venous route for later use.